Mean Portal Vein Diameter Research Articles

Sonographic Measurement and Sex Variability of Portal Vein in a Sample of Sudanese Adults

<i>Background: </i>Measurements of the normal portal venous dimension in a species population is so crucial. portal vein can be measured by several methods for assessing different parameters, Computed topography (CT) and sonographic imaging are common examples. The diagnosis of portal hypertension depends on the transverse portal vein diameter (normal diameter from 6-15 mm). The aim of this study is to assess the portal vein diameter and correlate the diameter with age, sex, weight, height and BMI in Sudanese populations. <i>Methodology: </i>This was a descriptive cross-sectional study that included a sample of Sudanese adults who were requested to have routine abdominal sonographic scanning due to reasons not related to liver or portal vein problems. The study was carried out at the Radiology Department of Qatar Alnada Hospital, Umbadda, Khartoum, Sudan 2022. <i>Results:</i> In this study, 376 participants were included of which more than half were females (56.1%, n=211), while 165 (43.9%) were males. The mean age of the participants was 38.12 + 15.57 years. The mean portal vein diameter was 10.79 + 1.27 millimeters. From this study the portal vein diameter varied with age (p value = 0.000), weight (p value = 0.002), height (p value = 0.000) and sex (p value = 0.000). It is not related to BMI (p value = 0.3). <i>Conclusion: </i>This study revealed that the portal vein diameter has positive correlation with age, sex, height, and weight of the person and has no correlation with the BMI.

Association of Anthropometric and Sociodemographic Factors with Portal Vein Diameter as Assessed by Ultrasonography: A Cross Sectional Study

Background: Portal vein is the vessel formed by the confluence of superior mesenteric artery and splenic vein. Its diameter varies with sociodemographic and anthropometric factors. Objective: To determine association of the normal portal vein diameter with sociodemographic factors and anthropometric factors using ultrasonography. Methodology: Three hundreds and eighty-five patients of both genders were randomly selected. The study participants were examined in radiology department of the Mardan Medical Complex by using ultrasonography technique to examine portal vein diameter, height was measured using tape, weight through weighing scale and BMI through SPSS. Results: The mean portal vein diameter in the population of district Mardan was 10.41±1.65mm. Portal vein diameter of normal individuals had positive correlation with sociodemographic factors such as gender, age and anthropometric factors such height, weight and body mass index. Conclusions: There was positive correlation between age, height, weight and BMI, correlation was statistically significant.

Normal Portal Vein Diameter (PVD) and Peak Systolic Velocity (PSV) in Healthy Iranian Children

Background: It is crucial to determine the normal Portal Vein Diameter (PVD) in different populations, and ages since changes in the size of the vein are used as an index in the diagnosis of some diseases. Therefore, it is important to determine its normal size. In this regard, the present study aimed to investigate the PVD and Peak Systolic Velocity (PSV) in healthy Iranian children. Methods: The present descriptive-analytical study examined 250 healthy Iranian children who visited the Imaging Center of the Children Medical Center of Excellence. The PVD and PSV were examined by a radiologist using a Doppler ultrasound. Children were classified intofive age groups: under one month, 1 month to 2 years, 2 to 6 years, 6 to 10 years, and 10 to 18 years, and the above-mentioned indices were measured and compared in them. Statistical analysis was conducted using SPSS 26 employing the Mann-Whitney, Kolmogorov-Smirnov, and Kruskal-Wallis tests. Results: In children under one month, one month to 2 years, 2-6 years, 6-10 years, and 10-18 years of age, the mean values of PVD were 4.08, 5.64, 6.14, 7.50, and 8.32 mm, and the mean PSV values were 19.26, 22.20, 21.68, 22.86, and 21.48, respectively. The mean PVD and PSV increased with increasing age; however, no statistically significant difference was found between the mean values of the indices in both boys and girls (P = 0.18). Conclusions: The PVD and PSV in healthy Iranian children were relatively similar to their non-Iranian counterparts, and the mean values increased with age. Additionally, no significant difference was found between the mean values of PVD and PSV in boys and girls based on gender.

The Value of Portal Vein Diameter in Evaluation of Chronic Liver Disease

Abstract Background: Chronic liver disease (CLD) such as cirrhosis is a risk factor for hepatocellular carcinoma and as such requires a reliable diagnostic surveillance. Hemodynamic changes are detected early using ultrasound scan. Ultrasound has been found to be an accurate and noninvasive method of assessing the portal vein hemodynamic changes in patients with CLD. Materials and Methods: This was a prospective case–control study conducted over a period of 6 months at the Federal Teaching Hospital, Gombe between September 2015 and February 2016. Portal vein diameter (PVD) of 100 adult male and female CLD patients were compared with 100 age- and sex-matched controls. Ultrasonography of the portal vein was used using HD-9 Phillips (2010) ultrasound machine. Statistical Package for the Social Sciences (SPSS) Windows version 20.0 package was used for data analysis, with P ≤ 0.05 was considered statistically significant with a confidence interval of 95%. The variables were expressed as range and mean ± standard deviation. All comparison of variables was done using the Student’s t-test for CLD and control. Pearson’s correlation coefficients and point-biserial correlation coefficient were used for the correlation analysis. Results: The mean PVD in normal subjects was 1.07 ± 0.60 cm and the respective value for CLD subjects was 1.50 ± 0.21 cm. There was a statistically significant difference in PVD between normal and CLD subjects (P = 0.001). The PVD correlated positively with age and sex in both CLD and controls. Conclusion: The PVD was significantly higher in CLD subjects than controls. PVD correlated significantly with age and sex in both CLD subjects and controls.

Correlation Between Portal Vein Diameter and Clinical Prognostic Scores in Patients with Liver Cirrhosis: A Cross-sectional Study

Introduction: Patients with liver cirrhosis develop portal hypertension, which leads to complications like splenomegaly, ascites, and oesophageal varices. Hepatic Venous Pressure Gradient (HVPG) measurement, the best available method to measure portal hypertension, is invasive and difficult to perform. Some studies suggest that an increased Portal Vein Diameter (PVD) on ultrasonography indicates portal hypertension and correlates with oesophageal varices. Studies correlating PVD with other complications of portal hypertension, like ascites and spleen size, are scarce. Aim: To correlate ultrasonographically measured PVD with clinical prognostic models: Child-Turcotte-Pugh (CTP) score and Model for End-stage Liver Disease (MELD), as well as with platelet count, in patients with liver cirrhosis. Materials and Methods: This was a cross-sectional study conducted in the Department of General Medicine in collaboration with the Department of Radiodiagnosis at Government Medical Collge, Chandigarh, India, from February 2021 to September 2021 over an eight-month period in a tertiary healthcare centre in North India. A total of 97 patients with cirrhosis, identified based on clinical features supported by laboratory tests and ultrasonography, were included in the study. A 6 mL of blood sample was collected from each patient for haemogram, biochemical tests (liver function tests and renal function tests), and coagulogram. Ultrasonography assessment of PVD, spleen size, and ascites was performed in a supine position using a right subcostal approach, after overnight fasting. The collected data were analysed using relevant statistical tests. Results: The mean age of the study population was 47.39 ± 12.64 years, with 73 (75.3%) males and 24 (24.7%) females. The most common aetiological factor for liver cirrhosis was alcohol, present in 52 (53.6%) patients. The mean PVD was found to be 12.31±2.71 mm. The correlation coefficient of PVD with spleen size was 0.3 with a p-value of 0.004, suggesting a positive correlation. The correlation coefficient of parameters like thrombocytopenia, CTP score, and MELD score was -0.2 (p-value=0.066), 0.1 (p-value=0.463), and 0.0 (p-value=0.725), respectively. Conclusion: Sonographically measured PVD cannot be used as a substitute for the clinical grading and staging of cirrhosis. Only a weak positive correlation was found between PVD and spleen size.

Abdominal Ultrasonography and Splenoportal Doppler Study for Predicting Oesophageal Varices in Patients Admitted with Chronic Liver Disease at a Tertiary Medical Hospital in Kolkata, India: A Cross-sectional Study

Introduction: Upper Gastrointestinal Endoscopy is considered the best screening tool for varices among patients with chronic liver disease. However, it is an expensive and invasive procedure that is not routinely available in rural India. Abdominal ultrasonography along with colour Doppler study is an inexpensive test commonly ordered for patients with chronic liver disease. Recent literature suggests that ultrasonographic parameters can be used to predict varices. Aim: To determine if ultrasonography of the entire abdomen and spleno-portal Doppler study findings can predict oesophageal varices in patients with chronic liver disease. Materials and Methods: The present hospital-based observational, cross-sectional study was conducted in the indoor ward of the Department of General Medicine at Medical College and Hospital, Kolkata, India, over a duration of one year from February 2021 to February 2022. Total 100 patients with chronic liver disease, admitted to the hospital ward, were included in the study. Child-Turcotte-Pugh (CTP) scores were obtained for all patients. Ultrasonographic and spleno-portal Doppler indices, such as liver size, spleen size, portal vein diameter, splenic vein diameter, peak systolic velocity of the portal vein, and portal vein/splenic vein diameter ratio, were measured alongside upper gastrointestinal endoscopy to detect varices. The data were analysed using Statistical Package for Social Sciences (SPSS) version 28.0. The Chi-square test was used to test for significant differences in proportions (categorical data), and the independent t-test and Analysis of Variance (ANOVA) with Tukey’s Post-hoc test were employed to test for significant differences in means (continuous data). Additionally, Receiver Operating Characteristic (ROC) curves were obtained for statistically significant parameters to predict the presence of varices. Results: The study enrolled 100 patients (63% males, 37% females) with a mean age of 49.19±14.965 years, ranging from 14 to 91 years. (median age of 52, range 14-91 years). Of these, 68 patients (68%) had oesophageal varices, while 32 (32%) did not. The study found that a mean spleen size of 13.55 cm, a mean portal vein diameter of 12.5 mm, and a mean splenic vein diameter of ≥9.05 mm were predictive of varices. Additionally, a mean portal vein/splenic vein diameter ratio of 1.6150 was also predictive of varices. However, there was no significant difference in mean liver size and peak systolic velocity between those with and without varices. Conclusion: The present study suggests that a spleen size, portal vein diameter, splenic vein diameter, and portal vein/splenic vein diameter ratio can be reliably used to predict oesophageal varices among patients with chronic liver disease.

Correlation between Portal Vein Diameter and Esophageal Varices Grades in Chronic Liver Disease Patients using Ultrasonography and Endoscopy as a Diagnostic Tool

Background: Chronic liver disease accounts for 2.2% of deaths and 1.5% of disability-adjusted life years. Variceal bleeding is one of the preventable caused of death in chronic liver disease. About 30-40% of patients with compensated cirrhosis and 85% of those with decompensated cirrhosis are found to possess EV on screening endoscopy.Objective: To determine the correlation between Portal Vein Diameter (PVD) on ultrasound examination and grades of Esophageal Varices (EV) on endoscopy in patients with Chronic liver disease (CLD). Material and Methods: This was a cross-sectional, correlational study, carried out in the Department of Diagnostic Radiology in collaboration with the Department of Gastroenterology, at Lady Reading Hospital Peshawar, Pakistan. A total of sixty patients were sampled via consecutive random sampling from Jan 2022 to Sept 2022. The criteria used for dilated portal vein was = 13mm and = 13 cm for splenomegaly. Results: Out of total 60 patients with CLD, PVD ranged from 10 to 18mm, mean PVD being 14.1mm ±1.4. The splenic sizes ranged from 10 to 23 cm, with the mean splenic cranio-caudal dimension being 14.9 cm ± 2.1. The highest association is between the large EV and PVD > 15 mm i.e., 52% of total large EVs. The differences between PVD to EV groups were statistically significant as determined by one-way ANOVA (F (2,57) =8.281, p= 0.001) and correlation was also statistically significant on Pearson's Correlation test (rs)[60] = 0.490, p < 0.001.Conclusion: As there is a significant positive correlation between PVD and grades of EV in CLD patients. The PVD on ultrasound should be utilized where an endoscopic facility is not available, or is overburdened, to prevent life threatening esophageal variceal bleed. Keywords: Chronic liver disease, Esophageal varices, Portal vein diameter.

Effectiveness of Duplex Doppler Sonography of Portal Vein as a Supplementary Tool in Diagnosis of Pediatric Appendicitis

Background Acute appendicitis is the most common surgical emergency in pediatric patients. Ultrasound is the preferred initial imaging modality to evaluate children with clinically- suspected appendicitis. whether by directly visualizing the inflamed appendix or by using secondary signs. However. rate of falsely negative or equivocal exams is still high, leading to a risk of complications from negative appendectomies as well as delayed diagnosis. Objective To evaluate the diagnostic accuracy of portal vein flow velocity and diameter in diagnosis of pediatric acute appendicitis Patients and Methods A cross-sectional study over the course of 6 months from June until November 2021. Portal vein diameter and peak systolic flow velocity were measured for 75 pediatric patients with clinically suspected appendicitis referred to radiodiagnosis department at Ain Shams University Hospitals for a pelvi-abdominal ultrasound examination. The largest appendix diameter secondary sonographic signs, and total leucocytic count were recorded if available. Results The mean age of the population was 112 ± 4.12 years (range. 3-18 years). Mean portal vein flow velocity was 38.94 ± 9.59 cm/s in the appendicitis group and 27.96 ± 6.98 cites in the non-appendicitis group. Median portal vein flow velocity was significantly higher in the appendicitis group (p < 0.001 with an overall diagnostic accuracy 82.1% at cut-off value of > 33.3 cm/sec. Mean portal vein diameter was 9.37±2.01 mm in the appendicitis group and 8.84 ± 2.19 mm in the non-appendicitis group, showing no statistically significant difference (P = 0.27). The presence of right iliac fossa echogenic fat was highly significant (P < 0.001) in predicting acute appendicitis. Conclusion The use of portal vein velocity as a supplementary tool improved the diagnostic performance and increased the sensitivity of ultrasound in diagnosing acute appendicitis. thus, decreasing the incidence of delayed appendectomies that have an increased risk of complications as well as decreasing the incidence of unnecessary appendectomies. Further studies are required to establish a comprehensive guideline to use it as a tool in ultrasound examinations of these patients.

A Study on Serum IL-6 Levels in Patients with Liver Cirrhosis of Any Cause and its Correlation with Child Pugh Score in Assessing the Disease Severity

Background: Liver cirrhosis is a chronic and progressive disease characterized by the development of fibrosis and distortion of the liver architecture. One potential biomarker that has gained attention in recent years is interleukin-6 (IL-6), a pro-inflammatory cytokine that plays a crucial role in the immune response and inflammatory processes. In the present study, serum IL-6 levels will be measured using enzyme-linked immunosorbent assay (ELISA) and correlated with the Child-Pugh score. Methods: This study was a cross-sectional design conducted at ASCOMS Jammu from June 2021 to November 2021. Fifty patients who presented with symptoms of liver cirrhosis, such as abdominal pain, abdominal distention, jaundice, and reduced urine output, were randomly selected from the outpatient or emergency departments. Results: The study analyzed data from 50 patients, finding that 6% were below the age of 30, 24% were between 30 and 40, and 70% were over 40. 94% of patients were male, while only 6% were female. The study found a significant increase in the mean portal vein diameter as the Child class increased, and a significant correlation between PT prolongation and mean IL-6 levels. However, there was no significant correlation between Child class and SAAG value. Conclusion: The severity of varices in patients with liver cirrhosis was found to be strongly associated with the level of serum IL-6, suggesting that serum IL-6 can be used as a non-invasive way to identify varices in patients with liver cirrhosis, particularly when OGD scopy is not available or if the patient is too sick to be moved to the OGD room. Elevated levels of IL-6 have also been associated with hepatic encephalopathy, liver fibrosis, and cirrhosis. Keywords: Interleukin 6, liver cirrhosis, hepatic encephalopathy, child Pugh score

Measurement of Normal Portal Vein Diameter by Ultrasound

Introduction: Measurement of the diameter of the portal vein may be particularly important in detecting and evaluating patients with portal hypertension as well as some other clinical disorders.This study is aimed at determining the mean portal vein diameter based on age, gender and anthropometric variables. Materials and Methods: A cross-sectional study was performed on a total of 195 apparently healthy individuals with overnight fasting and normal ultrasonographic findings of the liver. Portal vein diameter was measured and correlated with age, height, weight and BMI of the participants. Results: The mean portal vein diameter was 9.57 ± 0.66mm for both sexes. The mean value for males was 9.71 ± 0.67mm, and 9.46±0.64mm among females. There was a positive correlation between the PV diameter and age, height, weight and body mass index (P≤ 0.05). Conclusion: The measurement of the portal vein diameter using sonography is an important cornerstone for diagnosing patients with portal hypertension and also has a reasonable degree of accuracy.

Sonographic Assessment of Maternal Portal Vein Diameter in Healthy Pregnancy in South-South Nigeria

Background: The portal vein is one of the main sources of blood supply of the liver. About three quarters of the liver blood flow is from the portal vein.
 Objectives: To assess the mean normal portal vein diameter in healthy pregnant women, and correlate our observation with maternal age, parity and other baseline characteristics.
 Subjects and Methods: This descriptive, cross-sectional study was conducted at the Obstetrics and Radiology Units of the two tertiary health facilities, one secondary facility and one radio-diagnostic facility in Bayelsa State, South-South Nigeria, between April, 2022 and December, 2022. Data analysis was done using Statistical Product and Service Solutions for Windows® version 25, SPSS Inc.; Chicago, USA. Descriptive statistics (mean, standard deviation, frequency, and percentages) and Pearson product moment correlation were used for the analysis. The level of significance was set at p<0.05.
 Results: Mean portal vein diameter was 10.43 ± 1.58 mm, and ranged from 7.5 mm to 14.0 mm. Maternal age (ɼ = 0.51; p – 0.001) and parity (ɼ = 0.47; p – 0.001) correlated fairly strong and significantly with portal vein diameter. Gestational age (ɼ = 0.21; p – 0.001) and estimated foetal weight (ɼ = 0.16; p – 0.001) were significantly related to the portal vein diameter.
 Conclusion: This research has established baseline values for normal range of PV diameter in healthy pregnant women in the South-South region of Nigeria, and also revealed significant correlation of PV diameter with age, parity, gestational age and estimated foetal weight.

Prediction of Esophageal Varices by Non-Invasive Markers in Patients of Hepatic Cirrhosis due To Chronic Hepatitis C

Background: Esophageal varices develop as a consequence of portal hypertension in patients with chronic liver disease. Predicting the varices by non-invasive methods at the time of registration is likely to predict the need for prophylactic β blockers or endoscopic variceal ligation in patients with cirrhosis and portal hypertension. Objective: To evaluate the accuracy of combined non-invasive parameters in predicting the presence of esophageal varices in patients with hepatic cirrhosis due to chronic hepatitis C, using the positive predictive value (PPV) as a measure of performance. Methods: In this cross-sectional study conducted in the Department of Medicine, Unit-I, Sir Ganga Ram Hospital, Lahore, 125 patients fulfilling the inclusion criteria were included. Platelet count, Prothrombin Time/International Normalized Ratio (PT/INR) and portal vein diameter was assessed. Upper gastrointestinal endoscopy was done in all patients to check the presence or absence of esophageal varices. Results: Mean age of the patients was 52.52±8.39 years with 64% males. Mean PT was 10.09±3.13, mean INR was 1.75±0.22, mean platelet count was 83.56±13.47 while mean portal vein diameter was 13.79±0.84. In 61 patients (48.8%) esophageal varices were present on endoscopy and in 85 patients (68%) esophageal varices were predicted by combined non-invasive parameters. Positive predictive value of combined non-invasive parameters was 71.7%. Practical implications: Noninvasive predictors can be used as a screening tool to decide need for preventive drug therapy in esophageal varices and thus help reduce the workload and financial burden of routine endoscopies in all cirrhosis patients. Conclusion: The results suggest that combined non-invasive parameters may be a useful tool in the prediction of esophageal varices in patients with hepatic cirrhosis Keywords: Esophageal varices, Non-invasive predictors, Portal hypertension

Doppler Ultrasound Assessment of Portal Venous Flow Changes During Pregnancy

Background & Objectives: We aimed to evaluate portal venous flow changes during pregnancy by evaluating flow velocities and patterns in relation to gestational age. Methods: A total of 130 pregnant comprised (age, 18–45 years [mean, 29.3± 5.31 years]) were recruited. The subjects were divided into: Group 1: thirty four subjects in the 1sttrimester; Group 2: fifty five subjects in the 2nd trimester; and Group 3: forty one subjects in the 3rd trimesters. Portal vein diameter and maximum and minimum velocities were measured from the main portal vein. Spectral analysis was performed by calculating the portal vein pulsatility: minimum portal vein velocity divided by its maximum velocity. Results: The (mean±SD) maximum flow velocities (cm/sec) were higher in group 2 (31.58± 10.33) than those in groups 1 (29.44± 8.97) and 3: (26.8± 6.78), with a significant difference between groups 2 and 3. The mean minimum flow velocities were again higher in group 2: (20.89 ± 5.99) than those in groups 1 (17.71± 5.67) and 3 (18.2± 4.9) with a significant difference between groups 1 and 2. There were no statistically significant differences in mean portal vein diameter among the groups. The portal vein pulsatility value progressively increased with increasing gestational age from 0.60 in the first trimester to 0.68 in the third trimester, with statistical significant differences between groups 1 and 2 and groups 1 and 3. Conclusion: There is a significant increase in maximum portal vein flow velocity during the second trimester, with decreased waveform pulsatility with advancing gestational age.

Ultrasonographic Determination of Portal Vein Diameter Among Adults with and without Chronic Liver Disease at Selected Referral Hospitals in Southern Ethiopia.

BackgroundMeasuring portal vein diameter (PVD) is a feasible method of detecting portal vein hypertension, which is a primary and fatal complication of chronic liver disease (CLD) and is usually diagnosed very late. However, there is a paucity of morphometric information on portal vein diameter in the Ethiopian population. Hence, it is important to determine the portal vein diameter among adults with and without chronic liver disease.PurposeThe study aimed to identify how PVD is affected by age, sex, and anthropometric measurements in patients with and without CLD.MethodsA cross-sectional study was conducted among 220 participants (110 CLD patients and 110 controls) who have visited the radiology unit at selected Hospitals. Patients with CLD were selected consecutively as they present while controls were selected by a systematic sampling technique. A structured questionnaire was used to collect the data. Correlation and independent t-test were used to assess the relations. A statistically significant association was declared at P-value <0.05.ResultsMean portal vein diameter for CLD patients was 17.03±1.97 mm with a range of 12.8−20.8mm and 10.79±1.27mm with a range of 7.70–13.25mm for the control group. Age, weight, and body mass index had a positive correlation with portal vein diameter in both groups. The mean portal vein diameter increased by 21.34% during deep inspiration in the control group.ConclusionThe mean portal vein diameter among patients with CLD was higher than that of the control group. A significant gender-based difference was recorded in the portal vein diameter of the control group only. Ultrasonography is a non-invasive, readily available diagnostic tool for portal vein pathology.RecommendationIt is recommended for clinicians to take into consideration age, sex and anthropometric measurements while measuring PVD.

Determination of mean portal vein diameter: An approach with Computed Tomography

Purpose: The aim of study is to determine the range of values and upper limit of mean portal vein diameter (MPVD) in healthy individuals and to investigate the effect of gender, age, height, liver and spleen size, as well as body mass index (BMI) on these values. Material and Methods: In this retrospective study, the MPVD of the individuals with BMI between 18.5-24.9, without cardiac or liver disease, were evaluated by consensus of two radiologists on contrast-enhanced CT images. A total of 180 individuals, 15 men and 15 women from each decade between the ages of 20-80, were included. The correlation between the parameters was evaluated with Spearman’s correlation test. p<0.05 values were considered statistically significant. Results: MPVD was 12.75 ± 1.20 mm (SD), and mean BMI of the participants was 22.2 kg/m 2 . There was a positive correlation between MPVD and height and BMI (BMI; CI, 0.517-0.752, Height; CI, 0.536-0.719). In comparison by gender, MPVD was found to be significantly wider in males than in females. Conclusions: The results of our study indicate that acceptable value for the upper limit of MPVD is 13 mm, but the upper limit should be assessed according to body measurements such as BMI, height and gender in order to evaluate patients for portal hypertension. @font-face {font-family:Cambria Math; panose-1:2 4 5 3 5 4 6 3 2 4; mso-font-charset:0; mso-generic-font-family:roman; mso-font-pitch:variable; mso-font-signature:-536870145 1107305727 0 0 415 0;}@font-face {font-family:Calibri; panose-1:2 15 5 2 2 2 4 3 2 4; mso-font-charset:161; mso-generic-font-family:swiss; mso-font-pitch:variable; mso-font-signature:-469750017 -1073732485 9 0 511 0;}@font-face {font-family:Gentium Book Basic; panose-1:2 11 6 4 2 2 2 2 2 4; mso-font-alt:Calibri; mso-font-charset:0; mso-generic-font-family:auto; mso-font-pitch:variable; mso-font-signature:-1610612609 1073750090 0 0 19 0;}p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-unhide:no; mso-style-qformat:yes; mso-style-parent:; margin-top:0cm; margin-right:0cm; margin-bottom:8.0pt; margin-left:0cm; line-height:107%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:Calibri,sans-serif; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:Calibri; mso-fareast-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Times New Roman; mso-bidi-theme-font:minor-bidi; mso-ansi-language:EL;}.MsoChpDefault {mso-style-type:export-only; mso-default-props:yes; font-size:11.0pt; mso-ansi-font-size:11.0pt; mso-bidi-font-size:11.0pt; font-family:Calibri,sans-serif; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:Calibri; mso-fareast-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Times New Roman; mso-bidi-theme-font:minor-bidi; mso-ansi-language:EL;}.MsoPapDefault {mso-style-type:export-only; margin-bottom:8.0pt; line-height:107%;}div.WordSection1 {page:WordSection1;}

Splanchnic Vein Thrombosis in Liver Cirrhosis After Splenectomy or Splenic Artery Embolization: A Systematic Review and Meta-Analysis.

Splenectomy and splenic artery embolization are major treatment options for hypersplenism and portal hypertension in liver cirrhosis, but may lead to splanchnic vein thrombosis (SVT), which is potentially lethal. We conducted a systematic review and meta-analysis to explore the incidence of SVT in liver cirrhosis after splenectomy or splenic artery embolization and the risk factors for SVT. All relevant studies were searched through the PubMed, EMBASE, and Cochrane Library databases. The incidence of SVT in liver cirrhosis after splenectomy or splenic artery embolization was pooled. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Sixty-six studies with 5632 patients with cirrhosis were included. The pooled incidence of SVT after splenectomy and splenic artery embolization was 24.6% (95% CI 20.2-29.3%) and 11.7% (95% CI 7.1-17.3%), respectively. A meta-analysis of three comparative studies demonstrated that the incidence of SVT after splenectomy was statistically similar to that after splenic artery embolization (OR 3.15, P = 0.290). Platelet count, mean platelet volume, preoperative splenic or portal vein diameter, preoperative or postoperative portal blood velocity, splenic volume and weight, and periesophagogastric devascularization were significant risk factors for SVT after splenectomy. Postoperative use of preventive antithrombotic therapy was a significant protective factor against SVT after splenectomy. SVT is common in liver cirrhosis after splenectomy and splenic artery embolization. Coagulation and hemostasis factors, anatomical factors, and surgery-related factors have been widely identified for the assessment of high risk of SVT after splenectomy. Prophylactic strategy after splenectomy, such as antithrombotic therapy, might be considered in such high-risk patients. This study was registered in PROSPERO with a registration number of CRD42019129673.

Sonographic Assessment of Portal Vein Diameter among Healthy Adults in Saudi Arabia

Background: The purpose of this study was to evaluate the mean values of the portal vein diameter (PVD) and establish its ultrasound reference values in healthy Saudi adults. Methods and Results: A total of 124 healthy adult volunteers (45.2% males and 54.8% females, a mean age of 44.8 +/- 16 years), presenting at the US Department of El-Karama Medical Center in Riyadh, Saudi Arabia, were recruited between November 2018 and May 2019 for this prospective study. Abdominal ultrasound scans were conducted on a Hitachi Aloka F37 machine with a curvilinear transducer with a frequency of 3.5 MHz. The data collection sheets completed for each subject included the following variables: sex, age, height, weight, and BMI (kg/m(2)). The mean PVD was 10.40 +/- 1.22 mm and higher in men (10.7 +/- 1.1 mm) than in women (10.1 +/- 1.2 mm) (P<0.05). Study results showed that PVD did not correlate with age and BMI. Conclusion: Further large-scale studies are needed to establish ultrasound reference values for PVD in healthy Saudi adults.

Sonographic Comparison of Portal Vein Diameter in Cirrhotic and Non-Cirrhotic Patients

Background: Liver cirrhosis has become one of the major causes of morbidity and mortality. The burden of liver cirrhosis is growing in both the West and the East. In Pakistan death rate of liver cirrhosis is conspicuous because of chronic hepatitis (hepatitis B, C) and hepatocellular carcinoma. It is reported by World Health Organization that Pakistan occupies secondary place in spread of hepatitis C. Objective: To compare the portal vein diameter in cirrhotic and non-cirrhotic patients through ultrasound. Methodology: Ultrasound machine Toshiba Xario, Mindray dp 10 and G logic p5 with a curvilinear transducer of frequency 3.5 MHz was used. The study was conducted at, Hussain Diagnostic Ultrasound Centre Jampur, District Rajanpur. Data of 100 patients was collected through Cross-Sectional Analytical study. Statistical software for social sciences (SPSS version 22.0) is used for the analysis of data. Results: One hundred patients participated in this study. Among them, the minimum age was 30 and the maximum age was 70. Ratio of male patients was more than female patients, due to fact of more alcohol consumption in males. Out of 100 patients, 50 patients had cirrhosis and 50 were non cirrhotic. Liver cirrhosis patients came the severe symptoms like weakness, lethargy, hematemesis and melena. Non cirrhotic patients came with epigastric pain, nausea and vomiting. Mean of Portal vein diameter in non-cirrhotic patients was 10.5mm. Mean of Portal vein diameter in live cirrhosis patients was 14.8mm. A statistical significance difference was found between the two means of portal vein diameter of two groups (cirrhotic and non-cirrhotic) as the p-value 0.000 less than 0.05. Conclusion: Liver cirrhosis is one of the major issues of health and a big reason for increasing mortality rate all over the world. The most common etiology of liver cirrhosis .is .alcohol. Patients come with liver cirrhosis having severe symptoms like weakness, lethargy, hematemesis and melena. Non-cirrhotic patients come with mild symptoms like epigastric pain, nausea and vomiting, having normal portal vein diameter. Mean portal vein diameter in cirrhotic patients (14.8mm) was greater than non-cirrhotic patients (10.5mm). Key words: Liver cirrhosis, Non-alcoholic steatohepatitis (NASH), Non- alcoholic fatty liver disease (NAFLD), alcoholic liver disease (ALD). DOI: 10.7176/JHMN/76-12 Publication date: June 30th 2020

Pediatric acute appendicitis: Searching the diagnosis in portal vein.

Acute appendicitis is the most common reason for emergency abdominal surgery in the pediatric population. Ultrasound (US) is a widely used modality to diagnose acute appendicitis. The aim of this study was to evaluate the effectiveness of portal vein diameter and flow velocity in acute appendicitis diagnosis. Portal vein diameter and flow velocity were measured in children who were referred to radiology with a clinical diagnosis of acute appendicitis. The largest appendix diameter and leukocyte count of the patients were recorded. A control group was created which consisted of healthy children, and their portal vein diameter and flow velocities were also measured. The median age of the population was 10 years (range, 3-17 years). Mean portal vein diameter was 7.53 ± 1.55 mm in the control group, 7.92 ± 1.88 mm in the other diagnosis group, and 8.76 ± 1.91 mm in the acute appendicitis group. Mean portal vein diameter was significantly higher in the acute appendicitis group (p = 0.001). Median portal vein flow velocity was 17 cm/s (10-29 cm/s) in the control group, 18.3 cm/s (8-27 cm/s) in the other diagnosis group, and 20.5 cm/s in the acute appendicitis group. Median portal vein flow velocity was significantly higher in the acute appendicitis group (p = 0.00). Detecting an increase in portal vein diameter and/or flow velocity in equivocal cases may support other clinical signs associated with acute appendicitis. Portal vein diameter and flow velocity can serve as additional diagnostic markers in acute appendicitis cases.

Correlation between portal vein diameter and craniocaudal length of the spleen.

ObjectiveTo determine the correlation between portal vein diameter and spleen size (craniocaudal).MethodologyThe study was conducted at the University Ultrasound Clinic, The University of Lahore, Lahore Pakistan from 1st January to 1st July 2013. All the individuals who referred for abdominal sonographic examination, including male, female, older and younger were conveniently included in the study, voluntarily, irrespective of the disease state. Ultrasonographic measurements of the caudocranial length of the spleen and portal vein were carried out on all of the one thousand subjects. The subject position for spleen was supine or right posterior oblique during suspended inspiration and right anterior oblique position for portal vein diameter with quiet respiration. The correlation between the splenic length and portal vein diameter was evaluated.ResultA total of 1000 subjects; 36.9% females and 63.1% males aged from 4 to 79 years. The mean splenic length was 10.29 ± 1.89 cm. The mean portal vein diameter was 10.27 ± 1.78 mm. A statistically significant correlation was found between the spleen size and portal vein diameter; the Pearson correlation was significant at the 0.01 level.ConclusionPortal vein diameter is directly correlated to splenic caudocranial length. A regression formula was developed to measure the splenic length from the calculation of portal vein diameter.